Medicare Advantage plans come in a variety of types — two of the most common are PPO and HMO. Both types of plans offer different network and cost options.
Once you learn more about each plan type and how they work, it’ll be easier to choose the plan that’s right for you.
Medicare PPO and Medicare HMO plans use a network of physicians, hospitals, and other health care professionals to give you the highest quality care. The difference between them is the way you interact with those networks.
The biggest differences between PPO and HMO plans are network and cost. Let’s break it down for you.
With a PPO plan:
You don’t need a primary care physician. You can go to any provider you want without a referral — in or out of your network. The extra coverage and flexibility you get from a PPO means that these plans will typically have higher monthly premiums. Out-of-pocket costs can also run higher with a PPO plan, too.
With an HMO plan:
Typically, you’ll have lower monthly premiums and referrals are not needed. You can expect to pay fewer out-of-pocket costs, but you’re limited when it comes to which doctors you can see. HMO plans don't cover out-of-network care.
The decision should be about what’s most important to you.
Medicare PPO may be right for you if:
Medicare HMO may be right for you if:
Find out more about the difference in Medicare Managed Care plans, such as a Medicare HMO and a Medicare PPO plan and which gives you more benefits for the money.
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